comparison of three therapy-based interventions for preventing depression in adolescents

Conditions: Depression

Summary: this study will compare interpersonal psychotherapy-adolescent skills training (ipt-ast), ipt-ast plus parent involvement (enhanced ipt-ast), and usual care for the prevention of adolescent depression.

depression is a serious medical illness that is difficult to diagnose and treat, especially in children and adolescents. signs of depression in children may include the following behaviors: pretending to be sick; refusing to go to school; clinging to a parent; or worrying that a parent may die. older children may sulk, behave inappropriately at school, act in a negative or grouchy manner, or feel misunderstood. because normal behaviors vary from one childhood stage to another, it can be difficult to determine whether a child is going through a temporary "phase" or is suffering from depression. this study will compare ipt-ast, enhanced ipt-ast, and usual care for the prevention of adolescent depression. participation in this single-blind study will last approximately 21 months. participants will be randomly assigned to receive either ipt-ast, enhanced ipt-ast, or usual care for 12 weeks. ipt-ast is a school-based group intervention program that focuses on prevention, psychoeducation, and interpersonal skill-building. enhanced ipt-ast will entail ipt-ast plus three parent-adolescent sessions. usual care will consist of standard treatments and will not include ipt-ast. study visits will occur before and during the intervention at baseline and weeks 6 and 12. follow-up visits will occur 6, 12, and 18 months post-intervention. study visit assessments will include depression symptoms, anxiety symptoms, psychiatric diagnoses, overall functioning, social adjustment, parent-child conflict, perceived support from parents and peers, and service utilization.

Eligibility criteria:
inclusion criteria: * between grades 7 and 10 in school * score of at least 16 on the center for epidemiologic studies short depression scale (ces-d) * currently experiencing at least 2 symptoms on the k-sads depression section, one of which is either depressed mood, irritability, or an inability to feel pleasure during normal activities * score of at least 61 on the children's global assessment scale (cgas), indicating mild to moderate impairment * english-speaking exclusion criteria: * score of 15 or less on the ces-d scale * currently experiencing fewer than 2 depression symptoms on the k-sads or 2 or more symptoms on the k-sads with no report of depressed mood, irritability, or anhedonia * attempted suicide or self-mutilation in the year prior to study entry * current active suicidal ideation and/or history of a clinically significant suicidal behavior (i.e., with intent to die and high medical lethality) or repeated patterns of self-injurious behavior * current major depressive disorder or dysthymia as determined by k-sads * current dsm-iv diagnosis of psychosis, substance abuse or dependence, bipolar disorder, obsessive compulsive disorder, post-traumatic stress disorder, panic disorder, or conduct disorder as determined by k-sads * score of 60 or less on the cgas, indicating substantial functional impairment

Keywords: prevention adolescent